Comprehensive metabolic panel
Encyclopedia
The comprehensive metabolic
panel, or chemical screen, (CMP; CPT
code 80053) is a panel
of 14 blood test
s which serves as an initial broad screening
tool for physician
s, nurse practitioners and physician assistants. Because it is often ordered as a routine part of an annual physical examination
or check up, over time the CMP provides an important baseline of a patient's basic physiology
. Any changes or abnormal results, and in particular combinations of abnormal results, thus provides important initial data for differential diagnosis
, in which case more specialized tests may be indicated. In and of itself, however, the CMP provides an important gross check on the status of kidney
function, liver
function, and electrolyte
and fluid balance
.
In addition to being used at routine physicals of healthy patients, the CMP is routinely administered to monitor the status of a patient with a chronic disease, such as diabetes mellitus
or hypertension
.
Previous names for the panel of tests have been Chem 12, Chemistry panel, Chemistry screen, SMA 12, SMA 20 and SMAC (Sequential Multiple Analysis - Computer). The tests are performed on machines based on the AutoAnalyzer
invented in 1957.
for ten or twelve hours before the blood is drawn for the test. The following tests are then performed:
test in particular helps screen for diabetes mellitus and pre-diabetes. The calcium test can indicate or monitor bone diseases or diseases of the parathyroid gland or kidneys. Calcium salts, Lithium, Thiazide diuretics, Thyroxine, and vitamin D can all increase levels and may interfere with this test.
levels in the blood help screen for both kidney and liver disorders.
levels and the balance among them are tightly regulated by the body. Both individual values and ratios among the values are significant; abnormalities among either can indicate problems such as an electrolyte disturbance
, acid-base
imbalance, or kidney dysfunction.
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
panel, or chemical screen, (CMP; CPT
Current Procedural Terminology
The Current Procedural Terminology code set is maintained by the American Medical Association through the CPT Editorial Panel. The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among...
code 80053) is a panel
Test panel
A test panel is a predetermined group of medical tests as an aid in the diagnosis and treatment of disease.Test panels are typically composed of individual laboratory tests which are related in some way: by the medical condition they are intended to help diagnose , by the specimen type , by the...
of 14 blood test
Blood test
A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle, or via fingerprick....
s which serves as an initial broad screening
Screening (medicine)
Screening, in medicine, is a strategy used in a population to detect a disease in individuals without signs or symptoms of that disease. Unlike what generally happens in medicine, screening tests are performed on persons without any clinical sign of disease....
tool for physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
s, nurse practitioners and physician assistants. Because it is often ordered as a routine part of an annual physical examination
Physical examination
Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the taking of the medical history — an account of the symptoms as experienced by the patient...
or check up, over time the CMP provides an important baseline of a patient's basic physiology
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
. Any changes or abnormal results, and in particular combinations of abnormal results, thus provides important initial data for differential diagnosis
Differential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...
, in which case more specialized tests may be indicated. In and of itself, however, the CMP provides an important gross check on the status of kidney
Kidney
The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...
function, liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
function, and electrolyte
Electrolyte
In chemistry, an electrolyte is any substance containing free ions that make the substance electrically conductive. The most typical electrolyte is an ionic solution, but molten electrolytes and solid electrolytes are also possible....
and fluid balance
Fluid balance
Fluid balance is the concept of human homeostasis that the amount of fluid lost from the body is equal to the amount of fluid taken in. Euvolemia is the state of normal body fluid volume. Water is necessary for all life on Earth...
.
In addition to being used at routine physicals of healthy patients, the CMP is routinely administered to monitor the status of a patient with a chronic disease, such as diabetes mellitus
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
or hypertension
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
.
Previous names for the panel of tests have been Chem 12, Chemistry panel, Chemistry screen, SMA 12, SMA 20 and SMAC (Sequential Multiple Analysis - Computer). The tests are performed on machines based on the AutoAnalyzer
AutoAnalyzer
AutoAnalyzer is an automated analyzer using a special flow technique named "continuous flow analysis " first made by the Technicon Corporation. The instrument was invented 1957 by Leonard Skeggs, PhD and commercialized by Jack Whitehead's Technicon Corporation...
invented in 1957.
Testing
Typically, the patient fastsFasting
Fasting is primarily the act of willingly abstaining from some or all food, drink, or both, for a period of time. An absolute fast is normally defined as abstinence from all food and liquid for a defined period, usually a single day , or several days. Other fasts may be only partially restrictive,...
for ten or twelve hours before the blood is drawn for the test. The following tests are then performed:
General tests
These tests help screen for a wide variety of problems. The glucoseBlood sugar
The blood sugar concentration or blood glucose level is the amount of glucose present in the blood of a human or animal. Normally in mammals, the body maintains the blood glucose level at a reference range between about 3.6 and 5.8 mM , or 64.8 and 104.4 mg/dL...
test in particular helps screen for diabetes mellitus and pre-diabetes. The calcium test can indicate or monitor bone diseases or diseases of the parathyroid gland or kidneys. Calcium salts, Lithium, Thiazide diuretics, Thyroxine, and vitamin D can all increase levels and may interfere with this test.
- Serum glucose
- CalciumCalcium in biologyCalcium plays a pivotal role in the physiology and biochemistry of organisms and the cell. It plays an important role in signal transduction pathways, where it acts as a second messenger, in neurotransmitter release from neurons, contraction of all muscle cell types, and fertilization...
Protein tests
Tests of proteinProtein
Proteins are biochemical compounds consisting of one or more polypeptides typically folded into a globular or fibrous form, facilitating a biological function. A polypeptide is a single linear polymer chain of amino acids bonded together by peptide bonds between the carboxyl and amino groups of...
levels in the blood help screen for both kidney and liver disorders.
- Human serum albuminHuman serum albuminHuman serum albumin is the most abundant protein in human blood plasma. It is produced in the liver. Albumin constitutes about half of the blood serum protein...
- Serum total proteinSerum Total ProteinSerum total protein, also called plasma total protein or total protein, is a biochemical test for measuring the total amount of protein in blood plasma or serum....
(TP)
Electrolytes
ElectrolyteElectrolyte
In chemistry, an electrolyte is any substance containing free ions that make the substance electrically conductive. The most typical electrolyte is an ionic solution, but molten electrolytes and solid electrolytes are also possible....
levels and the balance among them are tightly regulated by the body. Both individual values and ratios among the values are significant; abnormalities among either can indicate problems such as an electrolyte disturbance
Electrolyte disturbance
Electrolytes play a vital role in maintaining homeostasis within the body. They help to regulate myocardial and neurological function, fluid balance, oxygen delivery, acid-base balance and much more. Electrolyte imbalances can develop by the following mechanisms: excessive ingestion; diminished...
, acid-base
PH
In chemistry, pH is a measure of the acidity or basicity of an aqueous solution. Pure water is said to be neutral, with a pH close to 7.0 at . Solutions with a pH less than 7 are said to be acidic and solutions with a pH greater than 7 are basic or alkaline...
imbalance, or kidney dysfunction.
- SodiumSodiumSodium is a chemical element with the symbol Na and atomic number 11. It is a soft, silvery-white, highly reactive metal and is a member of the alkali metals; its only stable isotope is 23Na. It is an abundant element that exists in numerous minerals, most commonly as sodium chloride...
- PotassiumPotassiumPotassium is the chemical element with the symbol K and atomic number 19. Elemental potassium is a soft silvery-white alkali metal that oxidizes rapidly in air and is very reactive with water, generating sufficient heat to ignite the hydrogen emitted in the reaction.Potassium and sodium are...
- Carbon dioxideCarbon dioxideCarbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...
(CO2) - ChlorideChlorideThe chloride ion is formed when the element chlorine, a halogen, picks up one electron to form an anion Cl−. The salts of hydrochloric acid HCl contain chloride ions and can also be called chlorides. The chloride ion, and its salts such as sodium chloride, are very soluble in water...
Liver function assessment
- Alkaline phosphataseAlkaline phosphataseAlkaline phosphatase is a hydrolase enzyme responsible for removing phosphate groups from many types of molecules, including nucleotides, proteins, and alkaloids. The process of removing the phosphate group is called dephosphorylation...
(ALP) - Alanine amino transferase (ALT or SGPT)
- Aspartate amino transferase (AST or SGOT)
- BilirubinBilirubinBilirubin is the yellow breakdown product of normal heme catabolism. Heme is found in hemoglobin, a principal component of red blood cells. Bilirubin is excreted in bile and urine, and elevated levels may indicate certain diseases...
See also
- Reference ranges for common blood testsReference ranges for common blood testsReference ranges for blood tests are sets of values used by a health professional to interpret a set of medical test results from blood samples....
- Basic metabolic panelBasic metabolic panelA basic metabolic panel is a set of seven or eight blood chemical tests. It is one of the most common lab tests ordered by health care providers. It provides key information that has a variety of applications in guiding the medical management of a patient...
- Medical technologistMedical technologistA Medical Laboratory Scientist is a healthcare professional who performs chemical, hematological, immunologic, microscopic, and bacteriological diagnostic analyses on body fluids such as blood, urine, sputum, stool, cerebrospinal fluid , peritoneal fluid, pericardial fluid, and synovial...
External links
- http://www.mgh.org/lab/CATALOG/TESTS/135.HTM — Reference rangeReference rangeIn health-related fields, a reference range or reference interval usually describes the variations of a measurement or value in healthy individuals...
for each test in the CMP